Paper spray mass spectrometry: A new drug checking tool for harm reduction in the opioid overdose crisis

Vandergrift, Gregory W.; Gill, Chris G.

doi:10.1002/jms.4431

Cited by 39 publications

(32 citation statements)

References 48 publications

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“…As a means to address these limitations, various alternative MS based strategies employing 'ambient ionisation' techniques for direct sample introduction have been investigated [32], including Desorption ElectroSpray Ionization (DESI) [37,38], Direct Analysis in Real Time (DART) [39][40][41][42], Low Temperature Plasma (LTP) ionization [43][44][45], Paper-Spray (PS) ionization [46][47][48][49], and Atmospheric Solids Analysis Probe (ASAP) [50].…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, these approaches enable rapid MS and MS/MS data acquisition with little or no requirement for sample preparation or separation prior to sample introduction [32], with sufficient sensitivity for trace-level analysis, and can be interfaced with portable mass spectrometry instrumentation [37,38,48,50,51] for direct qualitative or quantitative analysis of pharmaceutical and illicit drug substances including synthetic cathinones [37] and fentanyl and fentanyl-analogues [49], including when in the presence of other illicit drugs at significantly higher concentration [42].…”

Section: Introductionmentioning

confidence: 99%

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An Early Warning Monitoring System for Illicit Drug Use at Large Public Events: ‘Close to Real Time’ Trace Residue Analysis of Discarded Drug Packaging Samples

West¹,

Fitzgerald²,

Hopkins³

et al. 2021

Preprint

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Inspired by the exchange principle espoused by Edmond Locard (1877-1966), which states “every contact leaves a trace”, we report here the development and application of a strategy for trace residue sampling and analysis of discarded ‘Drug Packaging Samples’ (DPS), as part of an early warning monitoring system for illicit drug use at large public events. Using Direct Analysis in Real Time (DART) - mass spectrometry (MS) and -tandem mass<br>spectrometry (MS/MS), rapid and high-throughput identification and characterisation of a wide range of illicit drugs and adulterant substances was achieved, including those present in complex poly-drug mixtures and at low relative abundances, and with analysis times of less than one minute per sample. 1362 DPS were analysed either ‘off-site’ using laboratory-based instrumentation or in ‘on-site’ in ‘close to real time’ using a transportable mass spectrometer housed within a customised mobile analytical laboratory. 92.2% of DPS yielded positive results for at least one of 15 different pharmacologically active drugs and/or adulterants, including cocaine, MDMA, and ketamine, as well as numerous ‘novel psychoactive substances’ (NPS). Notably, polydrug mixtures were more common than single drugs, with 52.6% of positive DPS found to contain more than one substance, and with 42 different drug and polydrug combinations observed throughout the study. For analyses performed ‘on-site’, reports to key stakeholders including event organisers, first aid and medical personnel, and peer-based harm reduction workers could be provided in as little as 5 minutes after sample collection. Then, following risk assessment of the potential harms associated with their use, drug advisories or alerts were then disseminated to event staff and patrons, and subsequently to the general public, when substances with particularly toxic properties were identified.<br>

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An Early Warning Monitoring System for Illicit Drug Use at Large Public Events: ‘Close to Real Time’ Trace Residue Analysis of Discarded Drug Packaging Samples

West¹,

Fitzgerald²,

Hopkins³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…In recent years, drug-and adulterant-detecting technologies have been developed in such a way that devices are now able to quantify the components of drug specimens, and they are easier to use in the community (21,24,25). Devices such as portable mass spectrometers have the potential to amplify drug testing capabilities and related harm reduction messages and approaches (21,26).…”

Section: Introductionmentioning

confidence: 99%

Measuring adulterants in street drugs: Implementation of drug residue testing using portable mass spectrometry in a Northeastern U.S. harm reduction program, 2019-2020

Boulad

Matsumoto

Santelices

et al. 2021

Preprint

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Background: Fatal opioid overdose deaths involving illicitly manufactured fentanyl continue to escalate in the U.S. Drug checking services, as a harm reduction intervention for people who use drugs, has gained support as an effective strategy to reduce fatal overdoses. We examined implementation of drug checking services using portable devices in a syringe services program in the Northeastern U.S. Methods: Trained staff collected trace drug specimens from used paraphernalia provided by participants who requested drug checking services. All the specimens were tested using a portable mass spectrometer and sub-samples were tested for the detection of fentanyl using fentanyl testing strips. We assessed characteristics of participants who used drug checking services, self-reported types of trace specimens of substances that participants reported providing for testing, the actual mass spectrometer test results of these specimens, and agreement of the mass spectrometer and fentanyl testing strips results in detection of fentanyl and fentanyl analogues. Results: Of 155 unique participants who provided demographic information, 59% identified as male and 74.1% as White, with a mean age of 37.7 years. Based on analysis of 396 specimens tested with the portable mass spectrometer, the most common single substance detected was fentanyl (37.7%), without a trace of heroin or other adulterants, followed by methamphetamine (18.2%), and cocaine (13.6%). Fentanyl and fentanyl analogues were detected in specimens provided by participants that were reported as heroin (60.8%), cocaine (11.1%), and methamphetamine (6.7%). We found modest agreement of testing results between the mass spectrometer and fentanyl testing strips. Conclusions: Use of drug checking services within syringe services programs is in its initial test stages. Knowledge about the contents of substances purchased, and conversations between syringe services program participants and staff, have the potential to facilitate informed decisions to decrease overdose risks through engagement in harm reduction strategies. Through analysis of newly implemented drug checking services, we noted participant characteristics and dissonance between participants’ reports of the trace drug specimens submitted for testing and the actual drugs and adulterants detected by mass spectrometer results, which has implications for overdose risk, highlighting opportunities for harm reduction responses.

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“…PSI‐MS/MS has been employed previously for the analysis of imatinib, 11,17 and 15 other therapeutic drugs for monitoring purposes 18 . PSI‐MS/MS has also been reported for the quantification of various drugs of abuse 19 in whole blood, opioids in urine and analgesic slurry samples, 20,21 and other xenobiotics 22 . Previous PSI‐MS/MS studies highlight the importance of the assessment of matrix effect, ionization suppression, and recovery of the quantitative assay during direct biofluid analysis 15,23 .…”

Section: Introductionmentioning

confidence: 99%

Evaluating bioanalytical capabilities of paper spray ionization for abiraterone drug quantification in patient plasma

et al. 2020

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Paper spray ionization (PSI) is a direct, fast, and low-cost ambient ionization technique which may have clinical utility for qualitative and quantitative analysis of therapeutic drugs and metabolites from patient specimens. We developed and validated a PSI-mass spectrometry (PSI-MS/MS) method according to the US-FDA guidelines for bioanalytical studies to measure the prostate cancer drug abiraterone directly from patient plasma. The established linearity range was 3.1-156.8 ng/mL with a precision (%CV) and an accuracy (%) range of 0.5-10.7 and 93.5-103.2, respectively. The mean internal standard normalized matrix factor for abiraterone was just below 1 with highest %CV of 10.2 at the low-level quality control. In benchmarking the performance of this assay against a published LC-MS/MS assay, we showed they were mostly equivalent, with the exception of accuracy with clinical samples. We found the quantitative values observed for abiraterone measured directly from patient plasma using PSI-MS/MS showed positive bias. Upon investigation, we concluded the increased values were due to summed quantitation of isomeric abiraterone conjugates and metabolites which are separable by LC-MS/MS, but not with the current PSI-MS/MS configuration. Despite demonstrating the utility of PSI-MS/MS for rapid bioanalysis, this study also highlighted a limitation encountered with the direct analysis of abiraterone in clinical samples.

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Paper spray mass spectrometry: A new drug checking tool for harm reduction in the opioid overdose crisis

Cited by 39 publications

References 48 publications

An Early Warning Monitoring System for Illicit Drug Use at Large Public Events: ‘Close to Real Time’ Trace Residue Analysis of Discarded Drug Packaging Samples

An Early Warning Monitoring System for Illicit Drug Use at Large Public Events: ‘Close to Real Time’ Trace Residue Analysis of Discarded Drug Packaging Samples

Measuring adulterants in street drugs: Implementation of drug residue testing using portable mass spectrometry in a Northeastern U.S. harm reduction program, 2019-2020

Evaluating bioanalytical capabilities of paper spray ionization for abiraterone drug quantification in patient plasma

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